Coronavirus...what do we know? What about Pregnancy and Breastfeeding?

breastfeeding pregnancy Mar 01, 2020

We thought we would post a little update on Coronavirus and include what we know about it and how it might affect pregnant and breastfeeding women as well as our kiddos!

What is it?

Coronavirus is actually a family of viruses that can affect humans, animals and birds. What we are calling coronavirus is actually known as COVID-19. COVID-19 was first described in the Wuhan province of China and was thought to have spread from live animals sold at this market. It is a respiratory virus (like influenza or the common cold) which we think is spread by droplets, like from a cough, which is then transmitted to the mucosal surfaces (eyes, nose, mouth) of close contacts. This is important information to know for when we discuss how to help prevent transmission.

As of March 1, 2020 when we are writing this post there are a total of 87,701 cases if COVID-19, with 2995 deaths worldwide. This gives us a mortality rate of between 2-4%. This needs to be put in perspective, especially for us in the developed world with good access to supportive health care! Many of the early cases developed in areas where they did not necessarily have the ability to properly support the very ill people, whereas many of you reading this post are privileged enough to have access to good health care if you are having severe symptoms!.

In Canada we currently have 20 cases, and no deaths from COVID-19.

Do I need to worry about this?

Well sure, but I don't think we need to be more worried than for many of the other respiratory viruses which affect us from day to day!! The scariest piece of COVID-19 is the unknown, but as time is passing, it does not seem to be as dangerous as many of the viruses we have been exposed to in the past.

How is it spread?

We think it is spread through droplet transmission, which means an infected and symptomatic person will sneeze, and the droplets produced can land on surfaces that are then touched by someone else who then puts their hands on their face, or the coughed droplets land directly in our eyes, nose or mouth. What this means is that it needs close contact to spread it. There is no evidence showing that wearing a mask will prevent you from catching the virus. You should only wear a mask if you have a viral respiratory infection and are trying to prevent spreading it to others. Health care workers will wear special masks to avoid getting it in a hospital setting.

How do I prevent getting it?

The same rules apply to COVID-19 as should be applied to all other viruses out there...and we should be practicing these on a regular basis anyways!

Hand washing with soap and water for at least 20 seconds, regularly throughout the day, especially after being in public places, after coughing, or before touching our face.
Avoid touching your mouth, nose and eyes.
If you cough, cough into your elbow or a tissue, then throw that tissue away and wash your hands thoroughly with soap and water or use alcohol based hand sanitizer.
Clean and disinfect surfaces thoroughly with disinfectant or a water:bleach solution of 9:1.

What are the symptoms?

The symptoms are similar to those of many other respiratory illnesses which include:

fever
cough
shortness of breath in more severe cases

These symptoms seem to appear 2-14 days after exposure to the virus
The symptoms range from mild to severe. The vast majority of cases are mild and can be managed at home. We currently have no treatment other than supportive treatment with extra oxygen or breathing support if needed in the most sever cases.

What do I do if I think I've been infected?

If you are stable, and not having difficulty breathing, the most important thing to do is to rest and stay hydrated. You should quarantine yourself until your symptoms involve, to minimize spreading the disease to those around you. If you have severe symptoms involving difficulty breathing, you should call your local hospital prior to going to find out if they have any specific protocols to follow when presenting for care. There is no need to get seen by a physician if you are experiencing mild symptoms, and by doing so you risk infecting people around you! You can call your doctors office, and ask for someone to call you back to talk about your symptoms and how to care for yourself.

Self Quarantine involves:

If you have a mask, use it in shared spaces or maintain a two metre distance from household members.
Stay and sleep in a well-ventilated room separate from other people.
Use a separate bathroom if available.
Household members should stay in another area of the home or place of residence if possible, especially if they have compromised immune systems or chronic health conditions.
Restrict visitors until you recover.
Avoid sharing household items such as dishes, cups, eating utensils, towels, bedding, or other items. After using these items, wash them thoroughly with soap and water.
Monitor your symptoms

Pregnancy Concerns:

There is very limited information on COVID-19 and pregnancy. We know that high fevers in the first trimester can result in birth defects or miscarriage - so managing fevers with acetaminophen or Tylenol is important, like with any other viruses. The few case studies of pregnant women with COVID-19 who had a subsequent birth revealed that their infants were not infected with COVID-19 and there was no virus found in the amniotic fluid or their breast milk.

Pregnant women have a decreased immune system, and as a result are more susceptible to all viruses, and so practice good hygiene, as described above, is even more important for this group.

Breastfeeding:

Again, we have very limited information regarding COVID-19 and breastfeeding. The small case reports we do have from women who have recovered from COVID-19 reveal no virus in their breastmilk. In many other viruses, breastfeeding moms actually create antibodies to the virus, which helps to protect their babies. If a breastfeeding mom has a current viral infection it is important to help prevent the spread to their baby, while continuing to breastfeed. Things that can be done include:

handwashing with soap and water prior to touching your infant
avoid touching your infants face or hands
wearing a mask to prevent getting droplets on your infant while you are in close contact
thoughoughly disinfecting all areas your infant might touch with household cleaners or a bleach:water solution of 1:9 ratio
if pumping breastmilk - wash hands thoroughly before touching any of the pumping/bagging/bottling equipment and sterilize daily.

Children:

From what we know, children can be infected with COVID-19 but the vast majority of cases have been mild. Children who are immunocompromised or have respiratory diseases are most likely at a higher risk of contracting or having more severe illness as is the case with all respiratory viruses.

Similar hygiene practices should be taken with children as we suggest with adults.

Recap:

COVID-19 is not currently a significant risk in Canada
good hygiene practices should be undertaken
As with all viral respiratory infections, self quarantine should be undertaken to minimize exposure to others until symptoms resolve
Rare cases develop severe symptoms which may need support in a hospital setting
There are no known significant issues related to pregnancy, breastfeeding or children that differ from any other respiratory virus.

References:

https://www.cdc.gov/coronavirus/index.html

https://www.worldometers.info/coronavirus/

_Disclaimer:

_{She Found Health is meant for general medical information only. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This does not apply to every situation. If you have questions, or if you have received different advice please contact your health care provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.}

_{The views expressed by She Found Health and our guests are not representative of any institution with which we are affiliated.}

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